外周血MHR对糖尿病下肢微循环障碍治疗效果的预测价值OA

Objective To investigate the predictive value of peripheral blood monocyte(MONO)-to-high-density lipoprotein cholesterol(HDL-C)ratio(MHR)for the therapeutic effect in diabetic lower extremity microcirculatory disorders.Methods A total of 161 patients with diabetic lower extremity microcirculatory disorders from Nanjing Lishui People's Hospital from January 2022 to July 2024 were selected.After 6 months of standardized treatment,the therapeutic effects were evaluated,and the patients were divided into the effective group and the ineffective group.The baseline peripheral blood MHR levels of the two groups were compared.According to the MHR levels in peripheral blood,the patients were divided into Q1 subgroup,Q2 subgroup,and Q3 subgroup using the tertile method.The baseline data of the three subgroups were compared to analyze the factors influencing the therapeutic effect of the patients and evaluate the predictive value of peripheral blood MHR for the therapeutic effect.Results Three patients withdrew midway in this group.A total of 158 patients completed the treatment.Among them,50 patients showed significant improvement,67 patients were effective,and 41 patients were ineffective.The patients with significant improvement and effectiveness were included in the effective group(n=117),and the patients with ineffectiveness were included in the ineffective group(n=41).The baseline peripheral blood MONO and MHR of the ineffective group were higher than those of the effective group,and HDL-C was lower than that of the effective group(P＜0.05).There were significant differences in the three subgroups in terms of diabetes duration,hypertension,smoking,glycosylated hemoglobin(HbA1c),triglycerides,HDL-C,MONO,transcutaneous oxygen pressure,and laser Doppler blood flow(P＜0.05).Multivariate logistic regression analysis showed that diabetes duration,smoking,HbA1c,and MHR were independent influencing factors for the therapeutic effect of diabetic lower extremity microcirculatory disorder(P＜0.05);peripheral blood MHR had a significant negative nonlinear association with the risk of treatment failure(P-overall＜0.05,P-nonlinear＜0.05),and when MHR was greater than 0.42,the risk increased significantly.Based on the results of multivariate logistic regression analysis,a combined prediction model was constructed.The receiver operating characteristic(ROC)curve analysis showed that the area under the curve of this prediction model for predicting the therapeutic effect of diabetic lower extremity microcirculatory disorder was 0.911,which was higher than 0.814 of peripheral blood MHR and the value of other independent influencing factors alone(P＜0.05).Conclusion Peripheral blood MHR has a good predictive efficacy for the therapeutic effect in diabetic lower extremity microcirculatory disorders,and when combined with other independent influencing factors to build a joint prediction model,it can significantly enhance the predictive value.